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Total knee arthroplasty: analysis shows EXPAREL reduces length of hospital stay and improves discharge status compared to standard analgesic modality

Pacira Pharmaceuticals, Inc. has announced results of new data showing that EXPAREL® (bupivacaine liposome injectable suspension) infiltration compared to a standard analgesic regimen in patients undergoing total knee arthroplasty (TKA) significantly decreased the length of hospital stay and increased the likelihood that a patient would be discharged to their home rather than a care facility when released from the hospital. The poster, which is authored by researchers from Philadelphia College of Osteopathic Medicine (PA), Sinai Hospital of Baltimore (MD) and Plano Orthopaedics Sports Medicine and Spine Center (TX), is being presented at the American Academy of Orthopaedic Surgeons (AAOS) 2016 Annual Meeting in Orlando March 1st – 5th.

“The results of this analysis are encouraging because they suggest that the use of EXPAREL not only allows us to get our patients up and out of the hospital sooner, but also increases the likelihood we can send them directly home,” said Michael Mont, M.D., director of the Center for Joint Preservation and Replacement at Sinai Hospital and an author on the poster. “The ability to recover at home, rather than in a short-term nursing facility or rehabilitation center, not only lends itself to favorable hospital economics, but also – importantly – toward a more comfortable patient recovery experience.”

In this retrospective analysis, which was supported by Pacira, researchers reviewed data from the Premier hospital discharge database in order to identify patients ages 18 and older who underwent an inpatient TKA procedure between July 1, 2013 and June 30, 2014. The analysis compared 94,828 patients who had received either a standard analgesic regimen (80,160) or EXPAREL (14,668).

Key findings for patients receiving EXPAREL compared to the standard analgesic modalities included:

Nearly a half-day reduction in length of hospital stay (2.58 vs 2.98 days, respectively; p<0.001) More patients discharged directly to home rather than an interim care facility (73.2% vs 66.6%, respectively) A higher likelihood of being discharged home, according to a logistic regression analysis (OR=1.49 for patients in the EXPAREL group; p<0.001)

“Today’s dynamic healthcare environment of accountable care, bundled payments and patient satisfaction-driven reimbursement are evidence of the critical role of non-opioid options such as EXPAREL for postsurgical pain management,” said David Stack, chief executive officer and chairman of Pacira. “This analysis provides further evidence that the use of EXPAREL can have a substantial positive impact on patient outcomes while delivering strong value to the surgical community, hospital administrators and healthcare economics.”

EXPAREL is currently indicated for single-dose infiltration into the surgical site to produce postsurgical analgesia. The product combines bupivacaine with DepoFoam®, a proven product delivery technology that delivers medication over a desired time period. EXPAREL represents the first and only multivesicular liposome local anesthetic that can be utilized in the peri- or postsurgical setting. By utilizing the DepoFoam platform, a single dose of EXPAREL delivers bupivacaine over time, providing significant reductions in cumulative pain score with a decrease in opioid consumption; the clinical benefit of the opioid reduction was not demonstrated. Additional information is available at www.EXPAREL.com.

Important Safety Information

EXPAREL is contraindicated in obstetrical paracervical block anesthesia. EXPAREL has not been studied for use in patients younger than 18 years of age. Non-bupivacaine-based local anesthetics, including lidocaine, may cause an immediate release of bupivacaine from EXPAREL if administered together locally. The administration of EXPAREL may follow the administration of lidocaine after a delay of 20 minutes or more. Other formulations of bupivacaine should not be administered within 96 hours following administration of EXPAREL. Monitoring of cardiovascular and neurological status, as well as vital signs should be performed during and after injection of EXPAREL as with other local anesthetic products. Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL should be used cautiously in patients with hepatic disease. Patients with severe hepatic disease, because of their inability to metabolize local anesthetics normally, are at a greater risk of developing toxic plasma concentrations. In clinical trials, the most common adverse reactions (incidence greater-than or equal to 10%) following EXPAREL administration were nausea, constipation, and vomiting.

Please see the full Prescribing Information for more details available at: http://www.exparel.com/hcp/pdf/EXPAREL_Prescribing_Information.pdf